{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:05:26Z","timestamp":1792782326415,"version":"4.5.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":1926,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T00:00:00Z","timestamp":1599696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Rebirth Cluster of Excellence"},{"name":"Klinische Forschergruppe (KFO) 311"},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["HI-842\/11-1"],"award-info":[{"award-number":["HI-842\/11-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["HI-842\/4-3"],"award-info":[{"award-number":["HI-842\/4-3"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"German Federal Ministry of Education and Research","id":[{"id":"https:\/\/ror.org\/04pz7b180","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["HI\u2010842\/11\u20101"],"award-info":[{"award-number":["HI\u2010842\/11\u20101"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["HI\u2010842\/4\u20103"],"award-info":[{"award-number":["HI\u2010842\/4\u20103"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Peripartum cardiomyopathy (PPCM) is a heart disease affecting women during the last month of pregnancy or in the first months after delivery. The impact of the disease on mental health is largely unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Major mental disorders were assessed by a structured clinical interview in 40 patients with a confirmed PPCM diagnosis, and the data were compared with published prevalence in postpartum women. Circulating biomarkers associated with mental health, such as kynurenine, serotonin, and microRNA (miR)-30e, were evaluated in PPCM and compared with matched healthy pregnancy-matched postpartum controls (PP-Ctrl). Major mental disorders were diagnosed in 65% (26\/40) of the PPCM cohort. The prevalence for major depressive disorders was 4-fold, for post-traumatic stress disorder 14-fold, and for panic disorder 6-fold higher in PPCM patients compared with postpartum women without a PPCM diagnosis. Compared with PP-Ctrl, PPCM patients displayed elevated levels of serum kynurenine (P &amp;lt; 0.01), reduced levels of serum serotonin (P &amp;lt; 0.05), and elevated levels of plasma miR-30e (P &amp;lt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The majority of PPCM patients in the present cohort displayed mental disorders with a higher prevalence of major depressive disorders, post-traumatic stress disorder (PTBS), and panic disorder, compared with postpartum women without a PPCM diagnosis. This higher prevalence was associated with an impaired tryptophan metabolism and elevated levels of the depression-associated miR-30e, suggesting a potential predisposition for mental disorders at the time of PPCM diagnosis. Consequently, physicians should be aware of the increased risk for mental disorders in PPCM patients, and psychiatric assessment should be included in the diagnosis and management of PPCM patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.12967","type":"journal-article","created":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T07:54:23Z","timestamp":1601193263000},"page":"4394-4398","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Assessment of Major Mental Disorders in a German Peripartum Cardiomyopathy Cohort"],"prefix":"10.1093","volume":"7","author":[{"given":"Tobias J.","family":"Pfeffer","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str. 1, Hannover, 30625 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Berliner","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str. 1, Hannover, 30625 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str. 1, Hannover, 30625 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lotta","family":"Winter","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Ricke-Hoch","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str. 1, Hannover, 30625 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgeni","family":"Ponimaskin","sequence":"additional","affiliation":[{"name":"Cellular Neurophysiology, Hannover Medical School , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Schuchardt","sequence":"additional","affiliation":[{"name":"Department of Bio and Environmental Analytics, Fraunhofer Institute for Toxicology and Experimental Medicine , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Thum","sequence":"additional","affiliation":[{"name":"Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Hilfiker-Kleiner","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str. 1, Hannover, 30625 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Bauersachs","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str. 1, Hannover, 30625 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai G.","family":"Kahl","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,10]]},"reference":[{"key":"2026012114075188300_ehf212967-bib-0001","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1002\/ejhf.1493","article-title":"Pathophysiology, diagnosis and management of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy","volume":"21","author":"Bauersachs","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2026012114075188300_ehf212967-bib-0002","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1093\/eurjhf\/hfq120","article-title":"Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy","volume":"12","author":"Sliwa","year":"2010","journal-title":"Eur J Heart Fail"},{"key":"2026012114075188300_ehf212967-bib-0003","first-page":"173","article-title":"Cardiogenic shock complicating peripartum cardiomyopathy: importance of early left ventricular unloading and bromocriptine therapy","volume":"9","author":"Sieweke","year":"2018","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"2026012114075188300_ehf212967-bib-0004","first-page":"196","article-title":"Increased cancer prevalence in peripartum cardiomyopathy","volume":"1","author":"Pfeffer","year":"2019","journal-title":"JACC: CardioOncol"},{"key":"2026012114075188300_ehf212967-bib-0005","first-page":"1259","article-title":"Long-term follow-up in peripartum cardiomyopathy patients with contemporary treatment: low mortality, high cardiac recovery, but significant cardiovascular co-morbidities","volume":"18","author":"Moulig","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2026012114075188300_ehf212967-bib-0006","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.hrtlng.2017.05.004","article-title":"Depression and health behaviors in women with peripartum cardiomyopathy","volume":"46","author":"Rosman","year":"2017","journal-title":"Heart Lung"},{"key":"2026012114075188300_ehf212967-bib-0007","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/JCN.0000000000000518","article-title":"Psychosocial adjustment and quality of life in patients with peripartum cardiomyopathy","volume":"34","author":"Rosman","year":"2019","journal-title":"J Cardiovasc Nurs"},{"key":"2026012114075188300_ehf212967-bib-0008","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1007\/s00404-017-4313-0","article-title":"Serum serotonin, leptin, and adiponectin changes in women with postpartum depression: controlled study","volume":"295","author":"Yildiz","year":"2017","journal-title":"Arch Gynecol Obstet"},{"key":"2026012114075188300_ehf212967-bib-0009","doi-asserted-by":"crossref","DOI":"10.1126\/science.aaf9794","article-title":"Kynurenines: tryptophan's metabolites in exercise, inflammation, and mental health","volume":"357","author":"Cervenka","year":"2017","journal-title":"Science"},{"key":"2026012114075188300_ehf212967-bib-0010","doi-asserted-by":"crossref","first-page":"3924","DOI":"10.1038\/s41467-019-11876-5","article-title":"Attenuated palmitoylation of serotonin receptor 5-HT1A affects receptor function and contributes to depression-like behaviors","volume":"10","author":"Gorinski","year":"2019","journal-title":"Nat Commun"},{"key":"2026012114075188300_ehf212967-bib-0011","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jad.2015.12.082","article-title":"Perinatal anxiety disorder prevalence and incidence","volume":"200","author":"Fairbrother","year":"2016","journal-title":"J Affect Disord"},{"key":"2026012114075188300_ehf212967-bib-0012","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jad.2008.05.003","article-title":"Maternity blues as a predictor of DSM-IV depression and anxiety disorders in the first three months postpartum","volume":"113","author":"Reck","year":"2009","journal-title":"J Affect Disord"},{"key":"2026012114075188300_ehf212967-bib-0013","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jad.2016.06.047","article-title":"Mental disorders in adults with congenital heart disease: unmet needs and impact on quality of life","volume":"204","author":"Westhoff-Bleck","year":"2016","journal-title":"J Affect Disord"},{"key":"2026012114075188300_ehf212967-bib-0014","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1016\/S0140-6736(14)61276-9","article-title":"Non-psychotic mental disorders in the perinatal period","volume":"384","author":"Howard","year":"2014","journal-title":"Lancet"},{"key":"2026012114075188300_ehf212967-bib-0015","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jad.2014.12.041","article-title":"Magnitude and risk factors for postpartum symptoms: a literature review","volume":"175","author":"Norhayati","year":"2015","journal-title":"J Affect Disord"},{"key":"2026012114075188300_ehf212967-bib-0016","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1055\/a-0759-1981","article-title":"Postpartum depressive disorder\u2014psychosomatic aspects","volume":"79","author":"Schipper-Kochems","year":"2019","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"2026012114075188300_ehf212967-bib-0017","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/HRP.0000000000000162","article-title":"Depression and anxiety in heart failure: a review","volume":"26","author":"Celano","year":"2018","journal-title":"Harv Rev Psychiatry"},{"key":"2026012114075188300_ehf212967-bib-0018","doi-asserted-by":"crossref","first-page":"l1255","DOI":"10.1136\/bmj.l1255","article-title":"Stress related disorders and risk of cardiovascular disease: population based, sibling controlled cohort study","volume":"365","author":"Song","year":"2019","journal-title":"BMJ"},{"key":"2026012114075188300_ehf212967-bib-0019","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1176\/appi.ajp.2016.16010071","article-title":"A longitudinal study of adjustment disorder after trauma exposure","volume":"173","author":"O'Donnell","year":"2016","journal-title":"Am J Psychiatry"},{"key":"2026012114075188300_ehf212967-bib-0020","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.0000000000005816","article-title":"Longitudinal analysis of impulse control disorders in Parkinson disease","volume":"91","author":"Corvol","year":"2018","journal-title":"Neurology"},{"key":"2026012114075188300_ehf212967-bib-0021","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1001\/jamainternmed.2014.4097","article-title":"Dopamine receptor agonist drugs and impulse control disorders","volume":"174","author":"Weiss","year":"2014","journal-title":"JAMA Intern Med"},{"key":"2026012114075188300_ehf212967-bib-0022","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.4088\/JCP.v67n0818","article-title":"Anxiety disorders during pregnancy and the postpartum period: a systematic review","volume":"67","author":"Ross","year":"2006","journal-title":"J Clin Psychiatry"},{"key":"2026012114075188300_ehf212967-bib-0023","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.jad.2018.09.055","article-title":"Prenatal and postnatal maternal depression and infant hospitalization and mortality in the first year of life: a systematic review and meta-analysis","volume":"243","author":"Jacques","year":"2019","journal-title":"J Affect Disord"},{"key":"2026012114075188300_ehf212967-bib-0024","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/jcpp.12483","article-title":"Maternal perinatal mental health and offspring academic achievement at age 16: the mediating role of childhood executive function","volume":"57","author":"Pearson","year":"2016","journal-title":"J Child Psychol Psychiatry"},{"key":"2026012114075188300_ehf212967-bib-0025","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1001\/jamapsychiatry.2018.3667","article-title":"Association of maternal and paternal depression in the postnatal period with offspring depression at age 18 years","volume":"76","author":"Gutierrez-Galve","year":"2019","journal-title":"JAMA Psychiat"},{"key":"2026012114075188300_ehf212967-bib-0026","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1177\/0306624X10376204","article-title":"Maternal neonaticide following traumatic childbirth: a case study","volume":"55","author":"Nesca","year":"2011","journal-title":"Int J Offender Ther Comp Criminol"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.12967","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.12967","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/7\/6\/4394\/65901623\/eschf_7_6_4394.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/7\/6\/4394\/65901623\/eschf_7_6_4394.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:08:30Z","timestamp":1769022510000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/7\/6\/4394\/8372411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,10]]},"references-count":26,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,9,10]]},"published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.12967","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,9,10]]},"assertion":[{"value":"2020-02-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}